MNsure short on helpers as launch nears

A week before the launch of Minnesota's health exchange, no insurance agents, county workers or "navigators" have been fully trained and certified to help consumers enroll in coverage through the new system, state officials told legislators Tuesday.

There's still time for some consumer helpers to be trained before the Oct. 1 launch, April Todd-Malmlov, executive director of MNsure, said after a hearing at the state Capitol. And the last batches of online training materials for agents and navigators were released this week, while county workers should get their last training materials Monday.

But in the latest example of MNsure officials playing down the launch, Todd-Malmlov said it's not crucial that all advisers be ready to go by next week.

"We're not anticipating that there will be a lot of enrollment the first few weeks," Todd-Malmlov said in an interview. "Most people will come in (during) November and December -- that's our assumption."

Minnesota is creating a health insurance exchange as part of the federal Affordable Care Act, which requires that almost everyone have coverage next year or pay a tax penalty.

The law allows people to go without coverage for three months, so a person who buys health insurance March 31 and keeps it for the rest of the year could still comply with the coverage mandate.

MNsure's call center to advise consumers already is running, and Todd-Malmlov said Tuesday that the MNsure website is on track for consumers to use Oct. 1.

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Consumers don't have to seek help from a consumer adviser to obtain coverage through the health exchange.

Some states are further along than others in getting consumer assistance personnel trained for the new marketplaces, said Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation in Washington, D.C.

In Maryland, for example, more than 1,500 insurance agents and 74 navigators had been trained as of Tuesday.

In Illinois, more than 600 navigators had been trained as of Friday, and state officials expected at least 600 more would be trained by mid-October.

Connecticut has about 150 insurance agents certified to work with its exchange. As for navigators, the state -- like Minnesota -- is pushing to get workers certified.

"The certification test was posted several days ago, and the (navigators) are passing it every day," Kate Gervais of Access Health CT wrote in an email.

During a legislative oversight committee hearing Tuesday, Sen. Michelle Benson, R-Ham Lake, questioned officials about the readiness of three categories of assistance personnel -- navigators, insurance agents and county workers who will help people enroll in public health insurance programs through the exchange.

In Minnesota, all three groups are being trained through online modules and then will have to complete a test to show proficiency.

When Benson asked about the readiness of agents and navigators, Todd-Malmlov said: "None of them have completely finished that training." She said the training of county workers is "ongoing."

The state expects to release the final training module for county workers Monday -- a day before the MNsure launch, said Jim Golden, a deputy assistant commissioner in the state Department of Human Services.

"We think the number of new (public health insurance) cases will actually be quite modest in the first few weeks of October," Golden told legislators.

As of this week, all training modules for agents and navigators have been released, Todd-Malmlov said.

"We would have loved to have been able to do training earlier," she said. "What we and the federal government and other states are working with is a lot of system functionality coming up in a short window."

She added: "They're not going to be able to get on the system before they're trained."

Training includes instruction on keeping client information secure -- a sensitive issue at MNsure after a data breach this month when a now-former employee accidentally sent an email with Social Security numbers for more than 1,500 health insurance agents.

Noting that MNsure now acknowledges it didn't even need to collect Social Security numbers from insurance agents, Hoppe said: "People are nervous about this. People are nervous about their data."

In a statement after the meeting, Benson said the lack of completed training at this late date shows "the program is not ready for prime time."

It's not a dire situation if consumer assisters aren't ready to work with health exchange customers Oct. 1, said Tolbert of the Kaiser Family Foundation. She agreed with Todd-Malmlov's assessment that the key period for helping people enroll in coverage through health exchanges will come in November and December.

Still, leaving the training to the last minute constitutes a "lost opportunity," Tolbert said.

"To the extent that navigators aren't trained and completely ready on October 1, it does mean maybe there are some people who could have been reached then that you don't reach," she said. "Hopefully, you'll still be able to get to those people down the road. ... But they may not come back."